PURPOSE: To evaluate the role of MRI in the management of cervical cancer treated by conventional four-field whole pelvic irradiation. METHOD AND MATERIAL: Between 1993-march and 1994-february, 20 patients(4 Stage I B, 3 Stage U A, 13 Stage U B) with invasive cervical cancer were eligible for evaluation of accuracy of conventionally designed lateral treatment field without MRI determination. RESULTS: 5 out of 20 Patients had inadequate margin without MRI. The position of uterine fundus was more important than cervix in correction of field size and the center of treatment field. CONCLUSION: This Preliminary date show MRI determination of uterine position prior to radiotherapy planning is essential in the case of four-field whole pelvic irradiation technique.
Cervix Uteri ; Female ; Humans ; Magnetic Resonance Imaging* ; Radiotherapy* ; Uterine Cervical Neoplasms*

PURPOSE: Congenital hypothyroidism(CH) is not uncommon disorder, leading to retardation of mental development and growth, if not treated early. The aim of this study is to determine the factors influencing IQ of children with CH, diagnosed after 1 month of life. METHODS : Thirteen children with CH were included. They had intelligence test by KEDI-WISC(Korean Educational Development Institute-Wechsler Intelligence Scale for Children) and their medical records were reviewed. Their T4, TSH, height, age at diagnosis were investigated retrospectively. To evaluate the influence of T4, TSH, height, age at diagnosis on IQ, children were divided into three groups ; athyroid(n=8), sublingual(n=3), inborn errors of thyroid hormone synthesis(n=2) according to the result of thyroid scan. Results : In athyroid group, IQ closely correlated to VIQ and PIQ and had close relationship to T4 at diagnosis(.p=0.0086, r=0.8427), but no relation to TSH. There was no difference in height, T4 TSH, and IQ between athyroid and sublingual group. CONCLUSION : The results suggest that intellectual function in children with CH, diagnosed after 1 month of life depends on serum level of T4 at diagnosis. Further study is mandatory to elucidate the relationship between final IQ and factors, including thyroid function, age at diagnosis, adequacy of treatment, etc.
Child* ; Congenital Hypothyroidism* ; Diagnosis ; Growth and Development ; Humans ; Intelligence ; Intelligence Tests ; Medical Records ; Retrospective Studies ; Thyroid Gland

Effects of various peripheral vasoconstrictors on isolated porcine basilar and posterior communicating arteries(BA and PCA) were investingated and effected of flunarizine on the contractile responses were compared with those of a vasodilator, nitroglycerin. KCl elicited dose-dependent contractions in BA and PCA. 50mM KCl-induced contraction was not affected by nitroglycerin but dose-dependently inhibited by nimodipin and flunarizine in both rings. Epinephrine produced contractile response of BA and PCA in a dose-dependent fashion, but norepinephrine or phenylephrine did not cause obvious contraction by itself. Norepinephrine and phenylephrine elicited dose-dependent contractions in both rings treated with 10 -6M propranolol and the epinephrine-induced contractions were potentiated by pretreatment with propranolol, 5-hydroxytryptamine and histamine contracted BA and PCA in a dose-dependent manner and the contraction of PCA was more prominent than that of BA. In PCA rings, 10(-6)M 5-hydroxytryptamine and 10 -6M orepinephrine-induced contractions were not changed by nitroglycerin but inhibited by flunarizine in a dose-dependent manner. Small doses of flunarizine inhibited gradually both drug-induced contractions and large doses(3.5 x 10(-6) and 10(-6)M) steeply inhibit ed the contractions. Then the slopes of inhibitory curves in both cases were biphasic. Above results suggest that responsibility of catecholamine in porcine brain artery is more prominent in alpha-adrenoceptors than in beta-adrenoceptors, and inhibitory effect of flunarizine on brain artery results from inhibition of calcium influx through stimulated receptor-operated calcium channel(ROC) and potential-operated calcium channel(POC) .
Arteries* ; Brain* ; Calcium ; Epinephrine ; Flunarizine* ; Histamine ; Nitroglycerin ; Norepinephrine ; Passive Cutaneous Anaphylaxis ; Phenylephrine ; Propranolol ; Serotonin ; Vasoconstrictor Agents

Osteoporosis represents a reduced amount of bone tissue as compared with controls of same age and sex, and common feature of osteoporosis is a state of skeletal fragility leading to various fractures such as Colles' fracture, vertebral compression fracture, femur neck fracture, generally due to an inadequate amount of normally mineralized bone tissue, making the skeleton incapable of supporting normal mechanical demand. However it is difficult to quantify precisely its magnitude because of the variety of techniques used and the many bone sampling sites concerned. In 1970, Singh and associates(24.25) developed a method for grading the trabecular structure of the proximal end of the femur and reported that the femoral trabecular pattern index can clearly separate persons with osteoporosis from normal individuals. Cameron and its associstes developed an accurste method of determining bone mineral content by means of I-125 photon absorptiometry(5. 28). This method is consistently reproducible at the 98% level and has demonstrated agreement with ash measurement of cadaver bones at the 97% level. A comparative study of the usefulness of the femoral trabecular pattern index(Singh Index) and rsdial bone mineral content measurement by photon absorption was performed in 75 Kroean persons above forty years old. 25 of 75 persons were fracture patients due to osteoporosis. The results were as follows. 1. A significant difference in Singh index was noted between the fracture group snd control group. 2. A significant difference in bone mineral density was noted between the fracture group and control group. 3. A positive correlation was noted between the bone mineral denisty and Singh Index. 4. A significant difference in bone mineral density was noted between the fracture group and the control group which have same grade of Singh Index. So, we believe that bone mineral density is more objective and accurate than Singh Index. 5. We believe that both Singh Index and bone densitometer is useful in diagnosis and grading of osteoporosis.
Absorption ; Bone and Bones ; Bone Density ; Cadaver ; Colles' Fracture ; Diagnosis ; Femoral Neck Fractures ; Femur ; Fractures, Compression ; Humans ; Methods ; Miners ; Osteoporosis ; Skeleton

OBJECTIVES: The goal of this study was to examine the association between zinc and lead level and symptoms of attention-deficit hyperactivity disorder (ADHD) among Korean children. METHODS: A total of 89 clinic-referred children participated in the study (ADHD group=45, control group=44). The participants were 5-15 years old, and were mainly from urban areas of Seoul, Korea. ADHD was diagnosed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. We excluded children with a comorbid psychiatric disorder, medical illness requiring medication, or a prior history of taking ADHD medication. In order to evaluate the severity of ADHD symptoms, parents' Korean ADHD Rating Scale (K-ARS) was used. The ADHD diagnostic system (ADS) was used for evaluation of the severity of inattention and impulsivity. All participants completed the intelligence test and hair mineral analysis. Multiple regression analysis was used to examine the effect of hair zinc and lead levels on the K-ARS and ADS. We measured the predictive ability of the zinc and lead levels using logistic regression analysis. RESULTS: The lead level explained the score for omission errors, commission errors, and response time SD in visual ADS in the ADHD group (adjusted R2=.243, p<.01, adjusted R2=.362, p<.01, and adjusted R2=.275, p<.01), the score for omission errors of auditory ADS in ADHD group (adjusted R2=.407, p<.01) and the entire group (adjusted R2=.292, p<.01). Zinc was significantly explanatory for the K-ARS scores for the entire group (adjusted R2=.248, p<.001) and the ADHD group (adjusted R2=.247, p<.05). CONCLUSION: These findings suggest a possible role of zinc and lead in ADHD. Lead concentration in hair samples affected the ADS scores, and this was more prominent in children with ADHD. Children with ADHD had a lower zinc concentration in their hair, and the zinc concentration in hair showed negative correlation with the K-ARS score.
Child ; Hair* ; Humans ; Impulsive Behavior ; Intelligence Tests ; Korea ; Logistic Models ; Mood Disorders ; Reaction Time ; Seoul ; Zinc*

OBJECTIVES: The principal aim of the present study was to investigate the characteristic depressive symptoms in patients with social anxiety disorder (SAD) and panic disorder in comparison to patients with depressive disorder. METHODS: This study included 132 patients with SAD, 128 panic disorder and 64 depressive disorder (major depressive disorder, dysthymia etc.) patients without comorbid psychiatric disorders. The Beck Depressive Inventory (BDI) is used to measure depressive symptoms. We divided BDI into three categories originally described by Shafer AB, including negative attitude toward self, performance impairment, and somatic symptoms. We compared the depressive symptoms of SAD, panic disorder and depressive disorder by using ANOVA. RESULTS: Negative attitude toward self was noticeable in SAD (SAD 0.54 +/- 0.23, panic disorder 0.41 +/- 0.17, depressive disorder 0.46 +/- 0.11, p < 0.001). Performance impairment and somatic symptoms were remarkable in panic disorder than in SAD and depressive disorder (performance impairment : SAD 0.39 +/- 0.21, panic disorder 0.44 +/- 0.14, depressive disorder 0.40 +/- 0.09, p = 0.009 ; somatic symptoms : SAD 0.07 +/- 0.10, panic disorder 0.15 +/- 0.12, depressive disorder 0.14 +/- 0.08, p < 0.001). CONCLUSIONS: The results facilitate an approach to optimal treatment for patients with comorbidity of anxiety disorder and depression.
Anxiety Disorders* ; Anxiety* ; Comorbidity ; Depression* ; Depressive Disorder ; Humans ; Panic Disorder* ; Panic*

OBJECTIVE: Social anxiety disorder (SAD) shows relatively delayed responses to pharmacotherapy when compared to other anxiety disorders. Therefore, more effective early therapeutic decisions can be made if the therapeutic response is predictable as early as possible. We studied whether the therapeutic response at 12 weeks is predictable based on the early improvement with escitalopram at 1 week. METHODS: The subjects were 28 outpatients diagnosed with SAD. The subjects took 10-20 mg/day of escitalopram. The results of the Liebowitz social anxiety scale (LSAS), Hamilton anxiety rating scale, and Montgomery-Asberg depression rating scale were evaluated at 0, 1, 4, 8, and 12 weeks of treatment. Early improvement was defined as a ≥10% reduction in the LSAS total at 1 week of treatment, and endpoint response was defined as a ≥35% reduction in the LSAS total score. The correlation between clinical characteristics and therapeutic responses was analyzed by simple linear regression. The correlation between early improvement responses and endpoint responses was analyzed by multivariate logistic regression analysis and receiver operating characteristic curves. RESULTS: When we adjusted the influence of a ≥35% reduction in the LSAS total endpoint score on a ≥10% reduction of the LSAS total score at 1 week of treatment for the patients' age, the early improvement group at 1 week of treatment was expected to show stronger endpoint responses compared to the group with no early improvement. CONCLUSION: The results suggest that a ≥10% reduction in the LSAS total score in a week can predict endpoint treatment response.
Anxiety Disorders* ; Anxiety* ; Citalopram* ; Depression ; Drug Therapy ; Humans ; Linear Models ; Logistic Models ; Outpatients ; Phobic Disorders ; ROC Curve

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

To attempt a rigorous definition of the structure of the accessory spleen (AS) in the Chinese hamster, we examined twenty-one animals, and found AS in 5 animals (23.8%), which were over 7-month-old. The AS had no connection with the main spleen and was seen as a dark red oval organ (0.7 mm x 1.5 mm), which was embedded in the adipose tissue near the tail of the pancreas. It was demarcated from the adipose tissue and some pancreatic tissue. The organ was encapsulated by thin collagenous connective tissue and smooth muscle fibers, and contained lymphatic nodules, reticular fibers, nodular central arterioles, macrophages and megakaryocytes. Notably the incidence of AS appeared to increase with age in the Chinese hamsters.
Adipose Tissue/anatomy & histology ; Age Factors ; Animals ; Connective Tissue/anatomy & histology ; Cricetinae ; Cricetulus/*anatomy & histology ; Erythrocytes/cytology ; Lymphocytes/cytology ; Muscle, Smooth/anatomy & histology ; Pancreas ; Spleen/*anatomy & histology/cytology

No abstract available.
Diabetes Mellitus* ; Humans ; Neutrophils* ; Superoxides*